Pages

Friday, August 8, 2014

Five Days at Memorial - Sheri Fink

Fiction is awesome. I love it. Most of what I read is fiction. The idea of transporting yourself to another time and place captures me. I love investing in characters, learning their personalities and motivations, and, ultimately, understanding their actions. I am a big, big fan of fiction.

Good nonfiction, though, can do those things, too. Narrative nonfiction relates real life events in much the same way a fiction story would. It's a great middle ground, particularly if you want to read about real issues, but still have the story time pleasure of fiction.

I picked up Five Days at Memorial back in June. I originally thought it covered what happened at the Superdome in the aftermath of Hurricane Katrina. Not sure why the title didn't tip me off. Not a shining moment of intelligence for me. The book, in fact, relates the events that took place at one of New Orleans' private hospitals in those days.

Sheri Fink won a Pulitzer Prize for her investigative reporting of the events at Memorial Hospital. This book collects all that information and puts it in one place, as well as covering the official investigation that took place afterward.

Fink starts by giving a brief overview of Memorial's history, including its interactions with previous hurricanes. New Orleans' has long been susceptible to these storms and Katrina was not the first storm to flood the city. Since its opening about a century ago, however, Memorial had stood strong against the elements and provided shelter for thousands within its walls. Fink includes all this to mention that the hospital did have vulnerabilities and had faced tests before. She wanted to make sure "'the "hand of God" will not be blamed as often for what the hand of man has neglected to do.'"

After a short history, Fink spends the first half of the book relating what happened inside the hospital - or, at least, a conglomeration of varied accounts molded into a coherent story. Since the events, there has been controversy over exact conversations and timelines, as there would be after any stressful situation. This is the part of the book I easily found most interesting. I could not stop thinking how incredible it was for something like this to be happening in America. We think ourselves immune from these third world-like situations, but one blow from Mother Nature can put us on an even playing field with the poorest in the world if unprepared.
The second half of the book covers the legal battle which took place after accusations of euthanasia had been made. For me, this section got long-winded and very biased.

Fink definitely believes euthanasia took place (something I also agree with) and holds nothing back. To me, however, it doesn't make sense that Dr. Anna Pou is the one who received the brunt of the burden and accusations, even coming directly from Fink. It seemed as though there were many more people involved in this decision and action.

The whole story is fascinating and really causes the reader to think about human life in disaster situations. It's difficult to imagine yourself in a scenario in which decisions have to be made like those at Memorial. It was also interesting to learn about how medical procedure works in these situations. As Fink puts it, "concepts of triage and medical rationing are a barometer of how those in power in a society value human life." You clearly see different people at Memorial having different reactions and values over the course of the days they spent inside the hospital.

The most fascinating part of the book, for me, were the few pages that talked about how other hospitals and nursing homes in New Orleans handled the aftermath of the storm. Several other locations also had staff accused of euthanasia or abandonment of their wards. It's obvious, however, that "those who did better were those who didn't wait idly for help to arrive." Fink has just a few paragraphs about Charity Hospital, a public hospital, where things happened much differently than at Memorial.

"Leaders held regular morale-building meetings for all staff; "workers siphoned gas from cars to fuel ten small portable generators...used to power ventilators and cardiac monitors in the ICUS;" they maintained regular routine by encouraging normal shifts, sleep schedules, and patient services; most of all, rumors were actively squelched."

It was encouraging to see that chaos did not reign everywhere during that time. Charity sent their most sick patients out first, rather than keeping them for last, as Memorial did. Honestly, I wanted to read a whole chapter analyzing the contrasts between the two hospitals, rather than just a short interjection. I think the real answers to the big questions lie in the different approaches of the staffs and their leaders.

Five Days at Memorial deserves a read, particularly if you are unfamiliar with the story of what happened at Memorial, as I was. Take it all with a grain of salt, particularly the second half, as Fink recalls the legal proceedings. Above all, use the book as an opportunity to think through the scenario for yourself. It offers a unique opportunity to think through right and wrong and the value of life in disaster scenarios, and if those issues should be qualified at all by a "disaster scenario" or if they remain constant regardless of the situation.